Individual
CHRISTY WOODS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3209 HIBISCUS AVE, FORT PIERCE, FL 34947-7240
(772) 307-3825
Mailing address
3209 HIBISCUS AVE, FORT PIERCE, FL 34947-7240
(772) 307-3825
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
822596722
—
FL
Enumeration date
09/11/2018
Last updated
09/11/2018
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